Are crackles an appropriate outcome measure for airway clearance therapy?


Marques, Alda, Bruton, Anne, Barney, Anna and Hall, Andreia (2012) Are crackles an appropriate outcome measure for airway clearance therapy? Respiratory Care, 57, (9), pp. 1468-1475. (doi:10.4187/respcare.01625). (PMID:22348337).

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Description/Abstract

BACKGROUND: There is an urgent need to develop new outcome measures for respiratory therapy, to evaluate its effectiveness. Adventitious sounds generated from the lungs (crackles and wheezes), can now be quantified and characterized objectively with computer technology. To our knowledge, this is the first reported study designed to assess any change in lung crackles before and after a single session of airway clearance therapy.

METHODS: Twenty-three stable bronchiectasis patients were recruited from United Kingdom out-patient clinics and treated with a single session of airway clearance therapy, using the active cycle of breathing technique. Sound recordings were made before and after the session at 7 anatomical chest locations. Computerized lung sound analysis was used to measure crackle parameters: 2-cycle deflection width (2CD), and crackle number per breath cycle (nBC). Perceived breathlessness, lung function, and oxygen saturation data were also recorded.

RESULTS: Crackle mean 2CD and mean nBC increased post intervention. Sixteen participants (70%) showed a statistically significant difference in mean crackle 2CD before and after the session at ? 1 chest location. Thirteen (57%) participants had a difference between mean crackle 2CD before and after the intervention > 1 Smallest Real Difference (SRD, mean SRD = 2.23 ms) at ? 1 chest location. Differences in mean crackle nBC before and after the intervention did not exceed the SRD (mean SRD = 32 crackles per breath cycle) in any participant. Perceived breathlessness was significantly reduced post intervention; no significant changes were observed in either lung function or oxygen saturation.

CONCLUSIONS: Crackle duration (2CD) was found to change after a single session of airway clearance therapy, and shows promise as a new outcome measure for respiratory therapy interventions.

Item Type: Article
Digital Object Identifier (DOI): doi:10.4187/respcare.01625
ISSNs: 0020-1324 (print)
Subjects: R Medicine > RF Otorhinolaryngology
R Medicine > RM Therapeutics. Pharmacology
R Medicine > RT Nursing
Organisations: Signal Processing & Control Grp
ePrint ID: 210931
Date :
Date Event
17 February 2012e-pub ahead of print
1 September 2012Published
Date Deposited: 16 Feb 2012 13:45
Last Modified: 18 Apr 2017 00:25
Further Information:Google Scholar
URI: http://eprints.soton.ac.uk/id/eprint/210931

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